Stakeholder perspectives on the governance and accountability of Nigeria's Basic Health Care Provision Fund.

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Mary I Adeoye, Felix A Obi, Emily R Adrion
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引用次数: 0

Abstract

In recent decades, Nigeria has implemented a number of health financing reforms, yet progress towards Universal Health Coverage (UHC) has remained slow. In particular, the introduction of the Basic Health Care Provision Fund (BHCPF) through the National Health Act of 2014 sought to increase coverage of basic health services in Nigeria. However, recent studies have shown that health financing schemes like the BHCPF in Nigeria are suboptimal and have frequently attributed this to weak accountability and governance of the schemes. However, little is known about the accountability and governance of health financing in Nigeria, particularly from the perspective of key actors within the system. This study explores perceptions around governance and accountability through qualitative in-depth interviews with key BHCPF actors, including high-level government officers, academics and Civil Society Organizations. Thematic analysis of the findings reveals broad views among respondents that financial processes are appropriately ring-fenced, and that financial mismanagement is not the most pressing accountability gap. Importantly, respondents report that accountability processes are unclear and weak in subnational service delivery, and cite low utilization, implicit priority setting and poor quality as issues. To accelerate UHC progress, the accountability framework must be redesigned to include greater strategic participation and leadership from subnational governments.

利益相关者对尼日利亚基本医疗保障基金的管理和问责制的看法。
近几十年来,尼日利亚实施了一系列卫生筹资改革,但在实现全民医保(UHC)方面的进展仍然缓慢。特别是通过 2014 年《国家卫生法》引入了基本医疗保健提供基金(BHCPF),旨在提高尼日利亚基本医疗服务的覆盖率。然而,最近的研究表明,尼日利亚像基本医疗保健提供基金这样的医疗筹资计划并不理想,并经常将其归咎于计划的问责制和治理不力。然而,人们对尼日利亚卫生筹资的问责制和管理知之甚少,特别是从系统内主要参与者的角度来看更是如此。本研究通过对包括高级政府官员、学者和民间社会组织在内的尼日利亚卫生筹资计划主要参与者进行深入的定性访谈,探讨了他们对管理和问责制的看法。对调查结果进行的专题分析表明,受访者普遍认为财务流程已得到适当限制,财务管理不善并不是最紧迫的问责漏洞。重要的是,受访者报告说,在国家以下各级提供服务的过程中,问责程序不明确且薄弱,并指出利用率低、不明确的优先次序设定和质量差是问题所在。为了加快全民医保的进展,必须重新设计问责框架,使国家以下各级政府在战略上更多地参与和发挥领导作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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